缺血性脑梗塞,白质高强度和认知障碍在心房患者中增加
Philipp Krisai1,2, Stefanie Aeschbacher3,4, Michael Coslovsky4,5
1Cardiology Division, Department of Medicine, University Hospital Basel, University Basel, Basel, Switzerland. philipp.krisai@usb.ch.
Communications medicine
|January 27, 2026
概括
心房动 (AF) 与更多的大脑病变和较低的认知功能有关. 这种认知能力下降主要是由于AF本身,而不是它造成的脑损伤.
科学领域:
- 神经学 神经学
- 心脏病学 心脏病学
- 认知科学 认知科学
背景情况:
- 心房动 (AF),大脑病变和认知功能之间的关系尚不清楚.
- 了解这些联系对于管理AF患者至关重要.
研究的目的:
- 为了研究AF与大脑病变之间的关联.
- 为了确定AF对认知功能的影响.
- 探索大脑病变是否调解AF对认知的影响.
主要方法:
- 一项多中心前性研究 (瑞士-AF) 招募了1480名患有AF的患者和959名没有AF的患者.
- 使用MRI评估大脑结构,以确定心脏病发作和白质超强度 (WMH).
- 用蒙特利尔认知评估 (MoCA) 评估认知功能;采用因果调解分析.
主要成果:
- 与没有AF的患者相比,AF患者的脑梗塞 (40.1%vs24.0%) 和WMH (59.2%vs44.4%) 的患病率较高.
- 在患有AF (25.3) 的患者中,MoCA平均得分低于没有AF的患者 (26.4).
- 调解分析显示,AF对认知的总影响为-1.05 MoCA点,直接影响为-0.99和损伤介导影响为-0.06.
结论:
- 心房动与缺血性脑梗塞和WMH的较高负担有关,即使与可比的并发症有关.
- AF对认知功能产生负面影响,主要影响是直接的,而不是通过脑损伤介导的.
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